Little-Known PED, Blamed in Player's Death, Is Major Threat to Anti-Doping Fight

While the NFL argues over HGH testing and top baseball groups team up to put out a study about steroid usage, one of the drugs that recently came to light in the ongoing Biogenesis case out of Miami may be a bigger problem than either of those familiar substances.

With all that, it's not hard to see the threat of peptides as the latest problem for sports in their decades-long fight against performance enhancers. Simply put, these drugs could be killers, and expansion of their usage is a serious concern.

Let's be clear: "Peptides" is a broad category of substances. The term has come to be used generically, much in the way that "steroids" is used for a group of performance enhancers that are not actually anabolic androgenic steroids. In this case, we refer to substances that are technically known as GH secretagogues. Many peptides do have valid scientific or medical uses.

If these substances, such as GHRP-6 and CJ-1295, sound like lab experiments, it's because that is what they are. Peptides are not performance-enhancing in and of themselves, but they stimulate the production of substances inside the body that can then be enhancing. While HGH—human growth hormone—can be detected, the only way to detect the usage of something like GHRP would be to do a "biological passport" and note that the natural hormone levels had increased.

For most in the United States, the first sighting of these kinds of substances came in the documents leaked from Biogenesis, the Miami "anti-aging" clinic alleged to have provided banned performance enhancers to big-name MLB players like A-Rod and Melky Cabrera.

Jon Mannah, a player in Australia's National Rugby League, was 23 when he died recently of Hodgkin's lymphoma. The normally curable disease may have been re-ignited by the use of these peptides. Worse, the peptides reportedly were given to him by his team.

The same growth that these hormones create in the body also likely feed the growth and spread of cancer cells. Mannah was in remission from a previous bout with cancer, making it even more stunning that anyone would give him such substances.

Perhaps these news items will contribute to increased scrutiny of substances. But to this point, there has been little real scientific study.

Unlike HGH, which has been around for decades, or drugs like CERA or SARMs that came out of pharmacological testing, the particular peptides in question here are not being used for any approved medical treatments. And no American professional sport has them specified on a banned list (though catch-all language could make them a banned substance). Under these circumstances, any testing on these types of peptides has not been a publicized priority.

Still, it's surprising how few indications there have been that the peptides are being examined by major sports organizations. These aren't "new" substances. Increlex, a similar substance, is still not specifically banned by any league aside from MLB, despite being a known, in-use PED since 2004. I wrote about it being a loophole drug in baseball here in 2005! Peptides like GHRP-6 have been available since the mid-1990s.

But the attention of the NFL and MLB, for example, has been on HGH. And it was testosterone that made news last year in baseball's major leagues.

"They Work"

Anthony Roberts has been on the leading edge of performance-enhancing drugs for the past decade. As the author of Anabolic Steroids: Ultimate Research Guide, Roberts has his pulse on both the steroid underground and the drugs that are trickling into the mainstream. With peptides, Roberts says any fear they are being widely used is justified. "They work," he told me.

"These aren't actually new drugs, per se. They have been widely used in the bodybuilding community for the past several years...which generally means they are widely available on the Internet, through online storefronts and the like," Roberts said.

"The fact that they're potentially dangerous under certain conditions, or that we've seen some recent investigation into their use by athletes, isn't a reflection of their being new but rather a reflection of their being linked to a recent death (and perhaps their appearance on a list of drugs supposedly used by a certain ballplayer)."

Roberts noted that the authorities and governing bodies have noted the presence of the peptides, but that public consciousness of the issue lags.

"The FDA has been making busts in the peptide world for the past few years, although the only people taking notice are the people walking on this side of the street," he said, referring to the drug underground.

There's a problem with drugs coming into public consciousness. Once these peptides become more familiar, more and more people will try it, just as happened with anabolic steroids and HGH.

Formula for Increased Popularity

The normal pattern is that bodybuilders are the first to experiment with new substances. Since they do not operate under a testing program in most cases, they are not only free to use substances, they have a solid community that accepts these substances and shares results.

Once it escapes the bodybuilding community, a drug quickly reaches major sports. Football is normally first since the weightlifting component has a major overlap. This can quickly shift both vertically, down to college and scholastic levels, and horizontally, to other sports, major and minor. This pattern has been repeated again and again, since the first steroids went from the York Barbell Club to the nascent NFL.

These patterns became evident from my own study of the world of sports doping, detailed in my book The Juice.

But while the appearance of peptides in Australian sports, in the Biogenesis report and in Roberts' experience portends their spread through U.S. sports, they are not being publicized as a significant issue.

What we hear about in the news is that professional leagues continue to focus on HGH testing. MLB implemented broader blood testing for HGH during the 2013 season, despite having no positive tests in their 2012 debut. At the minor league level, there has been only one positive in four years of blood testing. WADA would not confirm the number of test-positive cases for this article, but anecdotal evidence indicates that the number is less than 10.

The NFL is still deadlocked on implementing its own policy on HGH. Michael Schottey of Bleacher Report broke down the issues in this article. It is clear that the NFL is moving in this direction largely due to public and political pressure. The NFL did not return calls or emails regarding this story.

Though Major League Baseball would not comment for this article, it stands to reason peptides are somewhere on its drug radar. MLB is currently engaged in a lawsuit against Biogenesis, seeking to gain access to clinic records that may shed more light on specific drugs.

Why should peptides be getting everyone's attention? Because they work, because there are signs they are becoming more popular and because anti-doping efforts can't afford to lag too far behind doping efforts.

Roberts has seen that peptides are effective: "Peptides work, in that they do exactly what they're meant to do—they raise your growth hormone levels to the point where you're getting a physiological advantage in recovery, strength, and lean muscle gains."

An effective, dangerous substance that's hard to detect? That's a major problem for sports and for those committed to keeping sports drug-free.

Quotes were obtained firsthand unless otherwise noted.

Will Carroll has been writing about sports injuries for 12 years. His work has appeared at SI.com, ESPN.com and Mind and Muscle.